Jump to content

Doctors and the Medical Profession


Recommended Posts

That's not my experience at all.

Having done medical transcription for 10-40 hours a week since 1983, in pretty much every medical specialty, I think I know what I'm talking about. Even when I had other jobs, I've always done it on the side for extra money.

 

you dare to put a mere 24 years of employment experience up against the two or three doctors omni knows? you can't expect us to take you seriously.

 

I just noticed this thread. Sorry for the late input.

 

Hmmm.... 2 people with different opinions.... one's opinion is more generalizible because she/he has more specific experience that you are aware of? I expect more of the academic mind. I'd expect that neither would be taken as more than opinion, that both could be taken seriously & that, before coming to any conclusion, more information would be needed.

 

But, if it'll help the survey, I'll put in my 25 years in the field, including the last 10 as Exec. Director of 2 hospitals and say that I agree with Omni -- almost all the doctors I know (by the way, I wouldnt trust me as the generalizible authority either) can spell med names, diagnoses and other things (including their own names)... the relevant question is usually whether they feel they need to and where. When they write scripts, they have to be careful with spelling... so they are. When they submit transcripts, they dont. It's possible that the transcripts KRamsey is seeing are being viewed as having a proofreader & they may not be viewed as needing to be 100% spell accurate by the doctor. We find lots of spelling errors in chart Progress Notes that are cleared up when transcribed or spell checked by the computer software we have. Bottom line: I wouldnt discount KRamsey's experience but wonder whether its directly relevant (or a spurious relationship) to the treatment provided to patients or even an individual Doctor's real knowledge or ability (which is the topic, isnt it?). Doctors can act real stoopid when they are tossing things off. Doesnt mean they're dumb.

Link to post
Share on other sites
  • Replies 140
  • Created
  • Last Reply

Top Posters In This Topic

Oh, and let's not even get into dictating the wrong arm or leg . . . that happens constantly. CONSTANTLY!

 

And Steve R., I mean no disrespect when I say this, but I feel that if hospital administrators would really try to understand the nuts and bolts of medical record creation in their particular medical centers, fewer errors would creep in.

 

*******

 

ETA: This is very telling: ". . . almost all the doctors I know can spell med names, diagnoses and other things (including their own names)... the relevant question is usually whether they feel they need to and where. When they write scripts, they have to be careful with spelling... so they are. When they submit transcripts, they dont."

 

Do good spellers just start to misspell willy-nilly because they don't feel like spelling correctly, depending on what task they're performing? That's a goofy assertion.

 

Okay, I blame my desire to yank Mongo's chain for being drawn into this but, what the hell, I'm here.

 

First of all, it's not "goofy"... I write these notes quickly & then, most of the time, use spellcheck and/or proofread my writing. The only reason I do is that I care that the final, lasting product of my older-by-the-minute mind will be on display for all to see & I dont want to be more embarrassed then necessary. It's not that I dont "feel" like spelling correctly to begin with, it's that I'm not taking the time to do it right the first time. In this case, it's because I have spell-check; in your case, they have you (and your peers)... you basically support my point with your illustrations of lazyness or uncaring tossing off of details. Knowing that they can always blame you or someone else & that you'll probably correct their mistakes is different than them not knowing how to spell or check facts when necessary, which appeared to be your original assertion based on where/when you made it. To generalize that it has a carry over to patient (mal)practice is a little much. After all, that's where you put your remark -- in the goodbye thread to H.L. -- I can only assume you're making a connection here.

 

So, now to the second piece.. your assertion about the malpractice associated with "constantly. CONSTANTLY!" dictating the wrong arm or leg leads me to believe that there are a lot of people walking (or limping) around with their original injury and an opposite side operation. And a lot of instant millionaires from the resulting lawsuits. Yes, malpractice rates are high because some doctors do damage, but "constantly" is either an exaggeration or offset by you and your peers correcting the mistake. Either way... please. Clearly, there isnt an epidemic of wrong sided operations, is there? Unfortunately, I know quite a few people who have had medical problems. Actually, I'm currently taking some prescription meds myself. None of us, to my knowledge, have been harmed by the results of a misspelled diagnosis or medication and none of us have hit the resulting lawsuit lottery. How many do you know? Is that an indication right up there with your assertions?

 

Thirdly, you're doing the same with me that you did with Omni... you had/have no idea if she knows a damn thing about doctors yet rate your personal experience ahead of hers and, here (disrespect intended or not) you have no idea if I do or dont "understand the nuts and bolts of medical record creation in (my) particular medical centers..." or what the error rate in my hospitals' charts may be. For all the hell you know, I wrote the software code myself. (no, I didnt, but I do know an awful lot about the record and what goes into it). Every med error, whether it reaches the patient or not, is reported and then looked at by our management team regularly for both individual follow up and trending. You feel free to generalize about my knowledge and distance from the issue. Doesnt help your credibility. At least Mongo does it to irritate certain individuals... you seem serious.

 

You have your opinion... that's nice. It's based on your experience... that's nice too. I have no reason to doubt you on either. But, I mean no disrespect either when I say, unless you're willing to show some aggregate data on any of the opinions you're sharing, it remains opinion... entertaining opinion perhaps, but not meaningful in any generalizible way. Regardless of how many capital letters or exclamation points you may use.

 

So there.

 

 

Link to post
Share on other sites
That's not my experience at all.

Having done medical transcription for 10-40 hours a week since 1983, in pretty much every medical specialty, I think I know what I'm talking about. Even when I had other jobs, I've always done it on the side for extra money.

 

you dare to put a mere 24 years of employment experience up against the two or three doctors omni knows? you can't expect us to take you seriously.

 

I just noticed this thread. Sorry for the late input.

 

Hmmm.... 2 people with different opinions.... one's opinion is more generalizible because she/he has more specific experience that you are aware of? I expect more of the academic mind. I'd expect that neither would be taken as more than opinion, that both could be taken seriously & that, before coming to any conclusion, more information would be needed.

 

well, the other party is not being prevented from providing further evidence that would predispose people towards taking them seriously. with the information available, kramsey's resume carries a lot more weight (of anecdotal experience).

Link to post
Share on other sites

steve, i hadn't seen your longer post before making my previous one. your experience obviously carries even more weight. let me point out, however, that what you say here:

 

It's not that I dont "feel" like spelling correctly to begin with, it's that I'm not taking the time to do it right the first time. In this case, it's because I have spell-check; in your case, they have you (and your peers)... you basically support my point with your illustrations of lazyness or uncaring tossing off of details. Knowing that they can always blame you or someone else & that you'll probably correct their mistakes is different than them not knowing how to spell or check facts when necessary, which appeared to be your original assertion based on where/when you made it.

 

is effectively the same as "can't spell". i mean, if my students would spell-check their papers better they wouldn't get as much red ink either.

 

i don't blame doctors, of course. for one thing, they're not as smart as us humanities academics; for another, they're too busy counting their money to bother with spelling.

Link to post
Share on other sites
they're too busy counting their money to bother with spelling.

 

 

You really, really don't know much about the current state of the medical profession.

 

the current state of the medical profession is that some physicians make obscene amounts of money and some don't, no different than most professions. The real money is made by the private, for-profit hospital corporations that own dozens of hospitals and regional medical centers.

 

My legal practice is about 90% medical negligence. I have litigated hundreds of cases against hospitals and physicians. These are a few of my observations: First, the overwhelming majority of physicians are talented, knowledgeable, conscientious, and dedicated to their patients. Less than 5% of physicians are responsible for 50% of the medical malpractice claims filed. It is the classic example of a few bad apples spoiling the whole bunch. If physicians would simply police themselves more and get more aggressive in revoking the licenses of the few bad doctors, they could cut the number of medical malpractice cases in half overnight. That said, sometimes good doctors make a bad mistake. This is negligence and this is why they are insured. It's the same reason that we must have insurance to drive our cars. No matter how careful we are, accidents do happen, and the cost of the loss should be born by the one who caused it. The sad thing is that the insurance carriers who cover physicians are terrible. They rip-off the physicians with massive, unjustified premiums, and then blame it on frivolous lawsuits. The concept of getting a "frivolous lawsuit" all the way to a jury trial in a medical malpractice case is laughable. it just doesn't happen.

 

98,000 deaths result each year directly from preventable medical errors in the hospital setting. This is the equivalent to a fully loaded 737 airplane crashing everyday, yet there is no outcry to overhaul our nations hospitals. Most of the errors are systemic in nature rather than the fault of a single, negligent employee. Since hospitals were purchased by large, for profit, corporations revenues and profit margins have increased by cutting the bottom line. This is usually accomplished by cutting staff. Talk to any person who has been a nurse for 25 years or more, and than him/her tell how things are different on the floor now. It is staggering. The same is true with housekeeping staff. Hospitals are not as clean as they used to be. Hospital acquired infections are raging as a result.

 

Having done this work for as long as I have my conclusions are that most doctors are good, most hospitals are run too much like a business, and injured people should always have a right to recover their full damages if they are due to another's negligence.

 

Link to post
Share on other sites
steve, i hadn't seen your longer post before making my previous one. your experience obviously carries even more weight. let me point out, however, that what you say here:

 

It's not that I dont "feel" like spelling correctly to begin with, it's that I'm not taking the time to do it right the first time. In this case, it's because I have spell-check; in your case, they have you (and your peers)... you basically support my point with your illustrations of lazyness or uncaring tossing off of details. Knowing that they can always blame you or someone else & that you'll probably correct their mistakes is different than them not knowing how to spell or check facts when necessary, which appeared to be your original assertion based on where/when you made it.

 

is effectively the same as "can't spell". i mean, if my students would spell-check their papers better they wouldn't get as much red ink either.

 

 

Well, sort of. I was reacting more to the "cant" part than the product getting to KRamsey. If I didnt have spell check and they didnt have him (her? sorry KR, I dont know your gender), maybe there'd be fewer mistakes because we'd take our time and think the words through. Splitting hairs? Maybe, but the "effectively the same as..." part isnt exactly correct either, is it? If KRamsey corrects the spelling before it gets in the chart, "effectively" it's the same as if they could spell. Only the person who's in the middle (the transcriber) sees the mis-spellings and my point is that this person cant tell the reasons for the original mis-spelling and shouldnt generalize outwards to the doctor's practice abilities from it.

Link to post
Share on other sites
oh, i know. the three doctors i know are constantly counting their money.

 

aha! But I know at least 50 doctors (well, more like over 100) and they cant count. So I'm right (wright? my spell check is off).

 

They can spell, but they cant count. :rolleyes:

Link to post
Share on other sites
deleted because I really don't give a shit about this conversation anymore

 

Well then, glad you couldnt edit out my post with your quotes as well.

 

Insult, insist you're correct, then edit it all out and walk away in a huff when agreement isn't unanymous unanimous (should've used spell check :blush: ) ? Good move. Thanks for sharing. I would have recommended leaving your posts up and just not responding any further as proof that you don't care any longer about this conversation. Editing it all out seems to indicate the opposite.

 

By the way, should I insist that transcribers, in general, aren't good grammarians, since the only one I have contact with doesn't capitalize in the beginning of a sentence and add a period at the end?

Link to post
Share on other sites
My legal practice is about 90% medical negligence. I have litigated hundreds of cases against hospitals and physicians. These are a few of my observations: First, the overwhelming majority of physicians are talented, knowledgeable, conscientious, and dedicated to their patients. Less than 5% of physicians are responsible for 50% of the medical malpractice claims filed. It is the classic example of a few bad apples spoiling the whole bunch. If physicians would simply police themselves more and get more aggressive in revoking the licenses of the few bad doctors, they could cut the number of medical malpractice cases in half overnight. That said, sometimes good doctors make a bad mistake.

 

One of my friends retired from his part-time position on a county board of dental review. This is where complaints go in NJ, and they have the power to recommend suspension or termination of licenses.

 

Every once in a while he would complain that his malpractice rates had gone up another 25%, and I'd ask him how many licenses had been suspended in the prior year or five years. He'd admit that they hadn't suspended any, although they had "sent a few warnings" usually to the same clowns.

 

I'd agree with Ron, overall. Until doctors are willing to clean their own ranks and demand quality in their operating environment, they're gonna pay through the nose in litigation costs. It's the same thing with priests, politicians, union leaders, insurance agents, and even lawyers. Until you're willing to isolate the bad actors, they will define your business.

Link to post
Share on other sites
steve, i hadn't seen your longer post before making my previous one. your experience obviously carries even more weight. let me point out, however, that what you say here:

 

It's not that I dont "feel" like spelling correctly to begin with, it's that I'm not taking the time to do it right the first time. In this case, it's because I have spell-check; in your case, they have you (and your peers)... you basically support my point with your illustrations of lazyness or uncaring tossing off of details. Knowing that they can always blame you or someone else & that you'll probably correct their mistakes is different than them not knowing how to spell or check facts when necessary, which appeared to be your original assertion based on where/when you made it.

 

is effectively the same as "can't spell". i mean, if my students would spell-check their papers better they wouldn't get as much red ink either.

 

 

Well, sort of. I was reacting more to the "cant" part than the product getting to KRamsey. If I didnt have spell check and they didnt have him (her? sorry KR, I dont know your gender), maybe there'd be fewer mistakes because we'd take our time and think the words through. Splitting hairs? Maybe, but the "effectively the same as..." part isnt exactly correct either, is it? If KRamsey corrects the spelling before it gets in the chart, "effectively" it's the same as if they could spell. Only the person who's in the middle (the transcriber) sees the mis-spellings and my point is that this person cant tell the reasons for the original mis-spelling and shouldnt generalize outwards to the doctor's practice abilities from it.

 

it is a little known fact that no doctor can cure a condition whose name and treatment options they cannot spell in confidence, without the support of spell-check. studies have shown that doctors who misspell the names of organs they're operating on are 7 times more likely to leave their cellphones inside the patient's body cavity (usually set to the vibrate position).

 

 

Link to post
Share on other sites
My legal practice is about 90% medical negligence. I have litigated hundreds of cases against hospitals and physicians. These are a few of my observations: First, the overwhelming majority of physicians are talented, knowledgeable, conscientious, and dedicated to their patients. Less than 5% of physicians are responsible for 50% of the medical malpractice claims filed. It is the classic example of a few bad apples spoiling the whole bunch. If physicians would simply police themselves more and get more aggressive in revoking the licenses of the few bad doctors, they could cut the number of medical malpractice cases in half overnight. That said, sometimes good doctors make a bad mistake.

 

One of my friends retired from his part-time position on a county board of dental review. This is where complaints go in NJ, and they have the power to recommend suspension or termination of licenses.

 

Every once in a while he would complain that his malpractice rates had gone up another 25%, and I'd ask him how many licenses had been suspended in the prior year or five years. He'd admit that they hadn't suspended any, although they had "sent a few warnings" usually to the same clowns.

 

I'd agree with Ron, overall. Until doctors are willing to clean their own ranks and demand quality in their operating environment, they're gonna pay through the nose in litigation costs. It's the same thing with priests, politicians, union leaders, insurance agents, and even lawyers. Until you're willing to isolate the bad actors, they will define your business.

 

Our bar association is extremely aggressive in pursuing disciplinary action against attorneys. It really takes very little to get disbarred, and I am grateful because it greatly reduces the number of legal malpractice claims filed each year and keeps my malpractice coverage reasonable.

 

 

 

Link to post
Share on other sites
98,000 deaths result each year directly from preventable medical errors in the hospital setting. This is the equivalent to a fully loaded 737 airplane crashing everyday, yet there is no outcry to overhaul our nations hospitals. Most of the errors are systemic in nature rather than the fault of a single, negligent employee. Since hospitals were purchased by large, for profit, corporations revenues and profit margins have increased by cutting the bottom line. This is usually accomplished by cutting staff. Talk to any person who has been a nurse for 25 years or more, and than him/her tell how things are different on the floor now. It is staggering. The same is true with housekeeping staff. Hospitals are not as clean as they used to be. Hospital acquired infections are raging as a result.

 

Having done this work for as long as I have my conclusions are that most doctors are good, most hospitals are run too much like a business, and injured people should always have a right to recover their full damages if they are due to another's negligence.

 

Those comments sent me scurrying to find a story I'd read in the past couple of months about a lifesaving procedural checklist designed to reduce the spread of infections in hospitals. I haven't found it but I did stumble across two intriguing items relevant to the discussion here:

 

http://www.newscientist.com/channel/health...colleagues.html

 

The gist:

 

24 per cent of physicians said they would refer patients to an imaging facility in which they had invested, without revealing this financial conflict. And 45 per cent of those who had encountered an incompetent colleague within the previous three years had failed to report their concerns

 

And this, on the current status of things with that checklist:

 

http://www.nytimes.com/2007/12/30/opinion/...amp;oref=slogin

 

The gist:

 

A year ago, researchers at Johns Hopkins University published the results of a program that instituted in nearly every intensive care unit in Michigan a simple five-step checklist designed to prevent certain hospital infections. It reminds doctors to make sure, for example, that before putting large intravenous lines into patients, they actually wash their hands and don a sterile gown and gloves.

 

The results were stunning. Within three months, the rate of bloodstream infections from these I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million.

 

Yet this past month, the Office for Human Research Protections shut the program down. The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island.

 

I am appalled.

 

 

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...